2013 E-Cig Research Wrap Up

[hanzo.esq]

A public lecture on e-cigarettes delivered by Dr. Lynne Dawkins on 3rd July 2013. She basically tells us who we are and what we are doing based on the current research.
Youtube - Electronic cigarettes: What we know so far

A quick search on her name reveals that she's been working on this topic for a while. It's probably fair to call her an expert.

The talk was so awesome, I took notes while listening.

Here's the punchline list:
- E-cigs are battery operated vaporizers used to deliver nicotine through inhalation (5:30)
- Liquid is PG, VG, Nicotine, and flavoring (5:30)
- Sales of ecigs double every year (11:00)
- Regulation in UK in Mdicines and Healthcare products (12:45)
- Regulation in US as general consumer product, but FDA soon
- E-cigs aren't really a tobacco product or a medicne (15:00)
- Most e-cig users are educated white males around 40 yro ex-smokers (16:15)
- Most common use duration is 10 months (17:30)
- 2nd gen e-cigs are the most common device (18:15)
- 18mg nic is most common (18:45)
- Almost no one uses 0mg nic (19:00)
- Most common flavor is tobacco (19:15)
- E-cigs are used as alternative to cigarette (20:00)
- There has been a big spike in use of e-cigs to quit smoking in the last year (20:45)
- Smoking is more than just a nicotine addition (21:15)
- E-cigs deliver nicotine once the user learns how to use it (23:45)
- Smoking is an efficient killer (29:30)
- The vast majority of people who try to quit smoking fail (31:15)
- Smoking is more than just a nicotine addition (33:15)
- The vast majority of heavy e-cig users successfully quit smoking, but more research is needed (36:15)
- Liquid is PG, VG, Nicotine, and flavoring (41:15)
- Drinking nicotine liquid is lethal (42:45)
- Need more studies on safety of inhaling flavors (43:30)
- PG is safe for oral consumption, but need more studies on safety of inhaling (44:00)
- PG probably causes dry mouth/throat (44:45)
- VG is safe for oral consumption, but need more studies on safety of inhaling (45:00)
- VG can be contaminiated with diethylene glycol (45:15)
- The FDA once found diethylene glycol in e-cigs in non-toxic levels (45:45)
- E-cigs contain similar toxins to cigarettes, but at significantly lower levels than cigarettes (46:30)
- E-cigs contain particulate matter at non-recommended levels, but at significantly lower levels than cigarettes (45.45)
- E-cigs are not safe, but they are much safer than cigarettes (49:00)
- Smokers and nicotine users should just stop (50:00)
- E-cigs are a reasonable harm reduction for stupid people who don't want to stop smoking (50:45)
- The kids that try e-cigs also try cigarettes (52:00)
- More research is needed to determine if kids use e-cigs as a gateway drug
- More research is needed to determine if e-cigs will normalize smoking (53:15)
- E-cigs are a reasonable harm reduction for stupid people who don't want to stop smoking (54:15)
- More research is needed to determine if e-cigs are a gateway to nicotine use (54:45)
- Enough research on vapor contents has been done to conclude that e-cigs are safer than cigarettes (55:45)
- Kids should not be allowed to drink liquid (57:00)
- Quality control, labeling, and proper use is a problem related to liquid (57:30)
- E-cigs are safer than cigarettes and effective at getting smokers to quit smoking (58:30)
- Over regulation may be counter productive to helping people quit smoking (59:15)
- Shout out to Amanda Roberts, John Turner, Kirsty Saw, UEL, Totally Wicked (59:30)

I am not a stenographer. Corrections welcomed.

Hanzo.

 

[TyPie]

Nice summary, and copious notes there, hanzo.
I'm particularly interested in the section, 'E-cigs are a reasonable harm reduction for stupid people who don't want to stop smoking'.

As one who has not watched the piece, and very little time to do so in the next several weeks, what's that all about? Can you summarize?

 

[hanzo.esq]

Nice summary, and copious notes there, hanzo.
I'm particularly interested in the section, 'E-cigs are a reasonable harm reduction for stupid people who don't want to stop smoking'.

As one who has not watched the piece, and very little time to do so in the next several weeks, what's that all about? Can you summarize?

For years I have been constantly and completely shamed about smoking. Only a stupid person could possibly want to smoke. I want to smoke, so I must be stupid.

It was self deprecating humor. I was entertaining myself. The correct paraphrase doesn't include the word "stupid." 54:15 (or so) is the minute mark in the video of her statement if you wanna hear exactly how she put it.

I didn't think anyone would actually read that far down anyway. Eh eh. I probably owe you a 10 mls of your favorite liquid now.

Hanzo.

 

[Mad Mick]

The Lecture is really informative and still quite current. The Video of Lecture covers all the arguments in an hour but it doesnt show the Slides.
Dr Lyn may not be the best presenter i've seen but is one of the foremost eCig researchers in the world - and on the side of sanity!

Video and Staff Page: Dr. Lynne Dawkins - School of Psychology Staff - UEL

Lecture Notes: http://www.uel.ac.uk/wwwmedia/schools/psychology/research/drugs/ecigarette-lecture_Dawkins.pptx

Now to track down all the research papers


Thankyou to Jaylavents from a UK Forum for these awesome notes:
Began research into ECigs in 2009
Sitting at parliamentary round table next week, guest request of Gerry Stimpsons. Discussing ECigs and MHRA impact.

Conflict of Interest declaration:
Sponsored research by TW
Sponsor has No control over research


Very knowledgeable about e-cigs and vaping in general- in particular cigalikes and ego tanks. Reference to mods but not dwelled upon.
Correct definitions and up to date research.

Talk will be available soon as slides and video stream from: http://Www.uel.ac.uk/ecigarettelecture

I found Dr Dawkins to be very aware of many important issues surrounding proposed regulation, and she confirmed her research so far has been very supportive of the success of ECigs in general and highlighted in particular that smokers have some success with ECigs in quit attempts but vapers self titrate more efficiently to control their level of nicotine. (more on this below)

If you are watching the video, the are a few misspoken mg/ml as micro grammes per ml, of course Dr Dawkins is a professor of Psychology and perhaps not as fluid with the chemistry terminology... But the data were correct.

Some notes I took in the lecture:
Ecig use risen from 2-12% in last two years
0.03% of users were non-smokers... No further information on the sources. Found this curious.
These data from 5000 respondents for source see:
Dawkins et al. (2013); Etter & Bullen (2011)

Current proportions of user products:
72% using PVs
18% using cigalikes
9% custom

Current proportions of e-liquid/carto strength
49% on 18mg/ml
33% on 11mg
1% on 0%

This highlights the importance of nicotine enjoyment level for users.

Smoking toolkit study West and Brown
Reports significant rise to 27% of quit attempts involving ECigs from 5% 6months ago.

Bullen showed even 0% Ecig placebo was 5%effective

Plasma studies: (have seen these before but included as per lecture)
Tobacco vs Ruyan Ecig
Ecig 1.3ng/ml blood after 20min
Tobacco plasma 13ng/ml after 20min (10x nicotine delivery and suspension)


Vansickel and Eisenberg (2013)
Studied experienced vapers
Showed users titrate nicotine to same levels as those of cigarettes

Dawkins and Corcoran under review

Showed different users maintain different levels
Highlights self titration as proof that people are different

[AFTER the lecture I talked with Dr Dawkins at length and highlighted the infeasibility of a single Ecig for all as planned by medicalisation, as this research shows different users require different products, and crucially, that vapers vape differently depending on their own personal levels of satisfaction. She agreed wholeheartedly]

Dawkins et al (2013)
88% saw a reduction in smoking over two weeks
74% of these were completely switched after two weeks

MBSiegel et al (2011)
6month abstinence 31%
Those using Ecig more than 20X per day showed 70% quit after 6 months

"Happy smokers" I.e didn't want to quit
40% quit over 6 months

Randomised controlled trials (these are the gold standard of search papers- these are what sway the ANTZ most)

Categoria study, Italy (measured nic total delivery- this was posted a few weeks back I think)
Of happy smokers 300ppl, different daily Ecig supply of nic
7.2mg total nic delivery---> 4.8mg total ---> 0mg total

1 year abstinence rates
7.2mg per day = 13%
9mg per day= 9%
0mgper day = 4%

Watch out for: Elusion (NZ) study result expected in autumn

goniewicz et al (2013)
Toxins are 9 to 450 times lower in ECigs

This was the polish study hat showed children are experimenting with ECigs but no context provided for whether they stayed on them and or went to smoking.
Unfortunately this study is being held up by ANTZ to support the gateway argument.

In order to combat that argument, research must prove that ecigs are less addictive than tobacco cigarettes by following new users who hadn't smoked before who are using freebase nicotine now.

Dr Dawkins is an academic who is forward thinking and supportive of Tobacco Harm Reduction as a common sense principle. Her work will help solidify the case for support and she is due to sit at a Parliamentary round table next week with Gerry Stimson, and we suspect the DoH.

 

[Ange3034]

Thank you for doing the leg work for me!

 

[Craybee]

can't wait to watch this. thanks for posting this video ... and the summations.